Mazzetto Roberto, Miceli Paola, Sernicola Alvise, Tartaglia Jacopo, Alaibac Mauro
Dermatology Unit, Department of Medicine (DIMED), University of Padua, 35121 Padova, Italy.
Hematol Rep. 2024 Jun 4;16(2):354-366. doi: 10.3390/hematolrep16020036.
Hypopigmentation disorders pose significant diagnostic challenges in dermatology, sometimes reflecting underlying hematological conditions. This review explores the clinical presentations related to hypopigmentation in hematological disorders, focusing on vitiligo, morphea, and syndromic albinism. Vitiligo, an autoimmune disorder targeting melanocytes, involves interactions between genetic polymorphisms and immune responses, particularly regarding CD8+ T cells and IFN-γ. Drug-induced vitiligo, notably by immune checkpoint inhibitors and small-molecule targeted anticancer therapies, underscores the importance of immune dysregulation. Morphea, an inflammatory skin disorder, may signal hematological involvement, as seen in deep morphea and post-radiotherapy lesions. Syndromic albinism, linked to various genetic mutations affecting melanin production, often presents with hematologic abnormalities. Treatment approaches focus on targeting the immune pathways specific to the condition, and when that is not possible, managing symptoms. Understanding these dermatological manifestations is crucial for the timely diagnosis and management of hematological disorders.
色素减退性疾病在皮肤科诊断中构成重大挑战,有时反映出潜在的血液系统疾病。本综述探讨血液系统疾病中与色素减退相关的临床表现,重点关注白癜风、硬斑病和综合征性白化病。白癜风是一种针对黑素细胞的自身免疫性疾病,涉及基因多态性与免疫反应之间的相互作用,特别是关于CD8 + T细胞和干扰素-γ。药物性白癜风,尤其是由免疫检查点抑制剂和小分子靶向抗癌疗法引起的,凸显了免疫失调的重要性。硬斑病是一种炎症性皮肤病,可能提示血液系统受累,如深部硬斑病和放疗后病变所见。综合征性白化病与影响黑色素生成的各种基因突变有关,常伴有血液学异常。治疗方法侧重于针对特定病情的免疫途径,若无法做到,则进行症状管理。了解这些皮肤表现对于血液系统疾病的及时诊断和管理至关重要。